Subscribe: Neuropsychology - Vol 24, Iss 1
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Neuropsychology - Vol 30, Iss 7

Neuropsychology focuses on (a) basic research, (b) the integration of basic and applied research, and (c) improved practice in the field of neuropsychology. The primary function of Neuropsychology is to publish original, empirical research on the relation

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Copyright: Copyright 2016 American Psychological Association

Is APOE ε4 associated with poorer cognitive outcome following traumatic brain injury? A meta-analysis.


Objective: Cognitive impairment is a common sequelae of traumatic brain injury (TBI); however, predicting who will experience poorer outcomes remains challenging. A potential risk factor that has gained attention is the APOE gene, with the ε4 allele hypothesized to have a detrimental effect on post-TBI cognitive outcome. The aim of this meta-analysis was to evaluate the effect of APOE ε4 both in terms of general cognitive function and within specific domains known to be prone to impairment following TBI (executive function, working memory, verbal memory and visual memory). Method: A literature search was undertaken in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA), resulting in the inclusion of 10 studies (ε4-carriers n = 143, noncarriers n = 510). Neuropsychological tasks were identified, and Cohen’s d was calculated and pooled. Meta-analyses were conducted on general cognitive functioning and for the specific cognitive domains of interest. Results: No significant differences were found between APOE ε4-carriers or noncarriers, either in general cognitive function or in the cognitive domains of executive function, working memory, verbal memory, or visual memory. Conclusions: This meta-analysis indicates that APOE ε4 does not have a detrimental effect on cognitive performance following TBI. We propose that the relationship between APOE and cognitive function following TBI is complex, and a more-nuanced exploration of APOE genotypes is needed. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Perseveration during verbal fluency in traumatic brain injury reflects impairments in working memory.


Objective: Previous studies of verbal fluency have reported higher rates of perseverative responses in both Alzheimer’s disease (AD) and traumatic brain injury (TBI) relative to control groups. These perseverations could arise from a number of impairments—for example, failures in working memory, inhibitory control, or word retrieval—and different clinical populations may show an increase in perseveration because of different underlying deficits. The objective of the current report is to investigate the cause of perseveration in verbal fluency in individuals with TBI and compare those results to a recent study of individuals with AD. Method: In a previous study, conducted by Miozzo, Fischer-Baum, and Caccappolo-van Vliet (2013), perseveration errors produced by individuals with AD were shown to have long lags between the 1st occurrence of a word and its repetition in verbal fluency, suggesting that perseverations were caused by a failure of the working memory mechanisms that control response monitoring. In the present investigation, we applied the same analysis to the perseveration errors produced during 197 administrations of the verbal fluency task with 143 individuals with TBI. Results: The perseverations of individuals with TBI showed a lag distribution similar to that of the AD population, with the lag between the 1st occurrence of a word and its repetition systematically longer than would be expected by chance. Conclusions: These results suggest that the perseverations produced during verbal fluency in individuals with TBI stem from the same working memory mechanism proposed in AD, rather than inhibitory control or word retrieval deficits. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

The contribution of posttraumatic stress disorder and mild traumatic brain injury to persistent post concussive symptoms following motor vehicle accidents.


Objective: Persistent postconcussive symptoms (PPCS) are a set of physical, cognitive, emotional, and behavioral symptoms that often follow mild traumatic brain injury (mTBI). Some of these symptoms also occur in posttraumatic stress disorder (PTSD). The current study examined the unique contribution of mTBI and PTSD to PPCS. The roles of neurocognitive and motivational factors were also addressed. Method: Sixty one children and adolescents (ages 6–18), at least 3 months post motor vehicle accident (MVA), participated in the study. All participants were diagnosed with PTSD symptoms. Thirty three participants met mTBI criteria, and 28 did not. Standard instruments for assessment included a semistructured clinical interview, self-report questionnaires, and a neuropsychological evaluation. Results: No differences were found between the mTBI and non-TBI groups on any of the emotional or neurocognitive measures, including PPCS symptoms. Multiple regression analyses revealed that emotional status, such as state anxiety and depression, were the best predictors of PPCS. Furthermore, hierarchical regression analyses revealed a double mediation model, in which suboptimal effort mediated the relationship between neurocognitive performance and PPCS, and emotional status mediated the relationship between suboptimal effort and PPCS. Conclusion: These findings underscore the importance of emotional status in the diagnosis of PPCS among children who suffer from PTSD. It is possible that PPCS reflect a more general expression of accident-related emotional distress, rather than being a direct result of the injury. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

A meta-analysis of working memory impairments in survivors of moderate-to-severe traumatic brain injury.


Objectives: To establish the magnitude of deficits in working memory (WM) and short-term memory (STM) in those with moderate-to-severe traumatic brain injury (TBI) relative to age-matched, healthy controls and to explore the moderating effects of time since injury and age at injury on these impairments. Method: Twenty-one studies that compared the WM and/or STM abilities of individuals with at least a moderate TBI relative to healthy controls were included in a random effects meta-analysis. Measures used to examine memory performance were categorized by modality (visuospatial, verbal) and memory system (WM, STM). Results: Individuals with TBI had significant deficits in verbal STM (Cohen’s d = .41), visuospatial WM (Cohen’s d = .69), and verbal WM (Cohen’s d = .37) relative to controls. Greater decrements in verbal STM and verbal WM skills were associated with longer time postinjury. Larger deficits were observed in verbal WM abilities in individuals with older age at injury. Conclusion: Evidence for WM impairments following TBI is consistent with previous research. Larger verbal STM and verbal WM deficits were related to a longer time postinjury, suggesting that these aspects of memory do not “recover” over time and instead, individuals might show increased rates of cognitive decline. Age at injury was associated with the severity of verbal WM impairments, with larger deficits evident for injuries that occurred later in life. Further research needs to chart the long-term effects of TBI on WM and to compare the effects of injury on verbal relative to visuospatial memory. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Hyposmia, not emotion perception, is associated with psychosocial outcome after severe traumatic brain injury.


Objective: The current study aimed to determine whether 2 variables associated with orbitofrontal damage, hyposmia and emotion perception deficits, are associated with socially disinhibited behavior and psychosocial outcome after traumatic brain injury (TBI). Methods: The Brief Smell Identification Test (BSIT), an emotion labeling task, an emotion intensity rating task, and an observational measure of social disinhibition were completed by 23 individuals with severe TBI. The disinhibition domain of the Neuropsychiatric Inventory and the interpersonal relationships subscale of the Sydney Psychosocial Reintegration Scale (SPRS-IR) were completed by a close other. Fifteen control participants provided norms against which to assess performance on the emotion intensity rating task. Results: BSIT scores predicted informant-reported change in interpersonal relationships on the SPRS-IR. Hyposmia, though, was not associated with informant-reported or observed social disinhibition. An impairment in accuracy scores on both emotion perceptions tasks was found for participants with TBI, yet intensity ratings did not differ between groups. This suggests that people with TBI are not actually impaired at detecting intensity of emotion but are less likely to perceive the target emotion as the dominant emotion. Emotion perception was not related to disinhibition or change in interpersonal relationships. Conclusions: These results support previous claims that hyposmia has prognostic significance following TBI. On the other hand, emotion perception impairment measured by standardized tasks does not appear to be an important factor in interpersonal outcomes. Finally, these results suggest that standardized emotion perception tasks may underestimate the emotion perception capabilities of people with TBI. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

“Cognitive, emotion control, and motor performance of adolescents in the NCANDA study: Contributions from alcohol consumption, age, sex, ethnicity, and family history of addiction”: Correction to Sullivan et al. (2016).


Reports an error in "Cognitive, emotion control, and motor performance of adolescents in the NCANDA study: Contributions from alcohol consumption, age, sex, ethnicity, and family history of addiction" by Edith V. Sullivan, Ty Brumback, Susan F. Tapert, Rosemary Fama, Devin Prouty, Sandra A. Brown, Kevin Cummins, Wesley K. Thompson, Ian M. Colrain, Fiona C. Baker, Michael D. De Bellis, Stephen R. Hooper, Duncan B. Clark, Tammy Chung, Bonnie J. Nagel, B. Nolan Nichols, Torsten Rohlfing, Weiwei Chu, Kilian M. Pohl and Adolf Pfefferbaum (Neuropsychology, 2016[May], Vol 30[4], 449-473). A problem with a computation to invert speed scores is noted and explained in this correction. All statements indicating group differences in speed scores, as well as Table 5 and Figure 8A, have been corrected in the online version of this article. (The following abstract of the original article appeared in record 2016-00613-001.) Objective: To investigate development of cognitive and motor functions in healthy adolescents and to explore whether hazardous drinking affects the normal developmental course of those functions. Method: Participants were 831 adolescents recruited across 5 United States sites of the National Consortium on Alcohol and NeuroDevelopment in Adolescence 692 met criteria for no/low alcohol exposure, and 139 exceeded drinking thresholds. Cross-sectional, baseline data were collected with computerized and traditional neuropsychological tests assessing 8 functional domains expressed as composite scores. General additive modeling evaluated factors potentially modulating performance (age, sex, ethnicity, socioeconomic status, and pubertal developmental stage). Results: Older no/low-drinking participants achieved better scores than younger ones on 5 accuracy composites (general ability, abstraction, attention, emotion, and balance). Speeded responses for attention, motor speed, and general ability were sensitive to age and pubertal development. The exceeds-threshold group (accounting for age, sex, and other demographic factors) performed significantly below the no/low-drinking group on balance accuracy and on general ability, attention, episodic memory, emotion, and motor speed scores and showed evidence for faster speed at the expense of accuracy. Delay Discounting performance was consistent with poor impulse control in the younger no/low drinkers and in exceeds-threshold drinkers regardless of age. Conclusions: Higher achievement with older age and pubertal stage in general ability, abstraction, attention, emotion, and balance suggests continued functional development through adolescence, possibly supported by concurrently maturing frontal, limbic, and cerebellar brain systems. Determination of whether low scores by the exceeds-threshold group resulted from drinking or from other preexisting factors requires longitudinal study. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Adaptive functioning following pediatric traumatic brain injury: Relationship to executive function and processing speed.


Objective: Pediatric traumatic brain injury (TBI) may affect children’s ability to perform everyday tasks (i.e., adaptive functioning). Guided by the American Association for Intellectual and Developmental Disabilities (AAIDD) model, we explored the association between TBI and adaptive functioning at increasing levels of specificity (global, AAIDD domains, and subscales). We also examined the contributions of executive function and processing speed as mediators of TBI’s effects on adaptive functioning. Method: Children (ages 8–13) with severe TBI (STBI; n = 19), mild-moderate TBI (MTBI; n = 50), or orthopedic injury (OI; n = 60) completed measures of executive function (TEA-Ch) and processing speed (WISC-IV) an average of 2.7 years postinjury (SD = 1.2; range: 1–5.3). Parents rated children’s adaptive functioning (ABAS-II, BASC-2, CASP). Results: STBI had lower global adaptive functioning (η2 = .04–.08) than the MTBI and OI groups, which typically did not differ. Deficits in the STBI group were particularly evident in the social domain, with specific deficits in social participation, leisure, and social adjustment (η2 = .06–.09). Jointly, executive function and processing speed were mediators of STBI’s effects on global adaptive functioning and in conceptual and social domains. In the STBI group, executive function mediated social functioning, and processing speed mediated social participation. Conclusions: Children with STBI experience deficits in adaptive functioning, particularly in social adjustment, with less pronounced deficits in conceptual and practical skills. Executive function and processing speed may mediate the effects of STBI on adaptive functioning. Targeting adaptive functioning and associated cognitive deficits for intervention may enhance quality of life for pediatric TBI survivors. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Differences in visual naming performance between patients with temporal lobe epilepsy associated with temporopolar lesions versus hippocampal sclerosis.


Objective: Naming difficulties are frequently observed in patients with temporal lobe epilepsy (TLE). Although damage/removal of regions of the anterior temporal neocortex including the temporal pole is considered critical for those difficulties, 1 relevant hypothesis proposes that hippocampal damage also has a role. Our aim was to better understand the specific involvement of temporal pole and hippocampus in visual object naming. Method: We assessed 2 types of patients with TLE on a visual confrontation-naming task: patients with hippocampal sclerosis (HS; n = 16) and patients with a lesion on the tip of the temporal pole that spared the hippocampus entirely (n = 18). A common battery of verbal and nonverbal semantic tasks was administered and used as a semantic memory background. Control group were 20 matched healthy participants. Results: Patients with lesions on their temporal poles differed from patients with HS and control group on naming ability, proportion and rate of error type, and influence of concept familiarity. Of note, naming performance was not affected by hippocampal damage. Using a Bayesian model averaging approach, we found that the number of omission errors distinguished patients with temporal pole damage from patients with HS and controls. This differential pattern occurred despite similar impairment on the semantic memory background in both clinical groups. Conclusion: Current findings provide evidence that temporal pole damage produces or contributes to naming impairment in TLE, while also suggesting that the hippocampus is not critical for naming. They also highlight the importance of error-type analysis when evaluating visual naming in TLE. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Retrogenesis of semantic knowledge: Comparative approach of acquisition and deterioration of concepts in semantic memory.


Objective: Semantic memory is the result of progressive development during childhood. During the construction of the lexico-semantic network, the features of the objects are progressively stored to build our knowledge. Alzheimer’s disease (AD) disrupts conceptual links that support semantic memory. Individuals suffering from AD lose access to words as well as to meaning. Some researchers have made the assumption that cognitive retrogenesis leads to a cognitive decline that reverses acquisition steps in childhood. This study proposes to analyze the validity of this theory applied to semantic knowledge. Method: We administered a semantic knowledge questionnaire (SKQ) featuring 30 objects associated with 4 questions (2 superordinate questions; Q1 = general; Q2 = intracategorial; and 2 subordinate questions; Q3 = perceptual; Q4 = thematical/functional) to 93 children (30 5-year-old children; 30 7-year-old children; and 33 9-year-old children), 32 healthy elderly people, and 66 AD patients (20 in the initial stage of the disease, AD1; 16 in the intermediate stage, AD2; and 30 in the advanced stage, AD3). Results: Our results show that the total number of errors in the SKQ evolved in a “u-shaped” curve: children made less and less errors at the SKQ during development while AD patients presented the reverse pattern. Moreover, the performance of 5-year-old children was identical to that of AD3 patients. Similar results were observed with 7-year-old children and AD2 patients, and with 9-year-old children and AD1 patients. Conclusion: These data are consistent with the idea of a lexico-semantic retrogenesis process. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Neural correlates of recognition and naming of musical instruments.


Objective: Retrieval of lexical (names) and conceptual (semantic) information is frequently impaired in individuals with neurological damage. One category of items that is often affected is musical instruments. However, distinct neuroanatomical correlates underlying lexical and conceptual knowledge for musical instruments have not been identified. Method: We used a neuropsychological approach to explore the neural correlates of knowledge retrieval for musical instruments. A large sample of individuals with focal brain damage (N = 298), viewed pictures of 16 musical instruments and were asked to name and identify each instrument. Neuroanatomical data were analyzed with a proportional MAP-3 method to create voxelwise lesion proportion difference maps. Results: Impaired naming (lexical retrieval) of musical instruments was associated with damage to the left temporal pole and inferior pre- and postcentral gyri. Impaired recognition (conceptual knowledge retrieval) of musical instruments was associated with a more broadly and bilaterally distributed network of regions, including ventromedial prefrontal cortices, occipital cortices, and superior temporal gyrus. Conclusions: The findings extend our understanding of how musical instruments are processed at neural system level, and elucidate factors that may explain why brain damage may or may not produce anomia or agnosia for musical instruments. Our findings also help inform broader understanding of category-related knowledge mapping in the brain, as musical instruments possess several characteristics that are similar to various other categories of items: They are inanimate and highly manipulable (similar to tools), produce characteristic sounds (similar to animals), and require fine-grained visual differentiation between each other (similar to people). (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Assessing neglect dyslexia with compound words.


Objective: The neglect syndrome is frequently associated with neglect dyslexia (ND), which is characterized by omissions or misread initial letters of single words. ND is usually assessed with standardized reading texts in clinical settings. However, particularly in the chronic phase of ND, patients often report reading deficits in everyday situations but show (nearly) normal performances in test situations that are commonly well-structured. To date, sensitive and standardized tests to assess the severity and characteristics of ND are lacking, although reading is of high relevance for daily life and vocational settings. Method: Several studies found modulating effects of different word features on ND. We combined those features in a novel test to enhance test sensitivity in the assessment of ND. Low-frequency words of different length that contain residual pronounceable words when the initial letter strings are neglected were selected. We compared these words in a group of 12 ND-patients suffering from right-hemispheric first-ever stroke with word stimuli containing no existing residual words. Finally, we tested whether the serially presented words are more sensitive for the diagnosis of ND than text reading. Results: The severity of ND was modulated strongly by the ND-test words and error frequencies in single word reading of ND words were on average more than 10 times higher than in a standardized text reading test (19.8% vs. 1.8%). Conclusion: The novel ND-test maximizes the frequency of specific ND-errors and is therefore more sensitive for the assessment of ND than conventional text reading tasks. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)

Processing speed, executive function, and academic achievement in children with dextro-transposition of the great arteries: Testing a longitudinal developmental cascade model.


Objective: To establish executive function (EF) structure/organization and test a longitudinal developmental cascade model linking processing speed (PS) and EF skills at 8-years of age to academic achievement outcomes, both at 8- and 16-years, in a large sample of children/adolescents with surgically repaired dextro-transposition of the great arteries (d-TGA). Method: Data for this study come from the 8- (n = 155) and 16-year (n = 139) time points of the Boston Circulatory Arrest Study and included WISC–III, Trail Making Test, Test of Variables of Attention, and WIAT/WIAT-II tasks. Results: A 2-factor model (Working Memory/Inhibition and Shifting) provided the best fit for the EF data, χ²(3) = 1.581, p = .66, RMSEA = 0, CFI = 1, NNFI = 1.044). Working Memory/Inhibition and Shifting factors were not correlated. In the structural equation model, PS was directly related to both EF factors and Reading at 8 years, and was indirectly related to Math and Reading achievement, both concurrently and longitudinally, via its effects on Working Memory/Inhibition. Shifting at 8 years was significantly associated with Math (but not Reading) at 16 years. Conclusions: The academic difficulties experienced by children and adolescents with d-TGA may be driven, at least in part, by underlying deficits in processing speed and aspects of executive function. Intervention efforts aimed at bolstering these abilities, particularly if implemented early in development, may prove beneficial in improving academic outcomes and, perhaps by extension, in reducing the stress and diminished self-confidence often associated with academic underachievement. (PsycINFO Database Record (c) 2016 APA, all rights reserved)(image)